Kristin Sharp, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

02006676A Issued in IN

Practice address

611 E Douglas Rd Ste 406
Mishawaka, IN 46545-1468

Phone

(743) 335-6580

NPI assigned

Mar 20, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Michigan State University College of Osteopathic Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Saint Joseph Regional Medical Center-South Bend Campus IncGroup PAC ID 3476451790, 65 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Joseph Regional Medical Center Hospital, Mishawaka, IN, CCN 150012

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ksharp1147625@direct.trinity-health.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Saint Joseph Regional Medical Center-South Bend Campus, Inc

  • Mobile Mammography Clinic/Center
  • South Bend, IN
  • NPI 1023844693
  Medicare reassignment Care Compare group NPD
• Saint Joseph Regional Medical Center- Plymouth Campus Inc

  • Family Medicine Physician
  • Plymouth, IN
  • NPI 1538585187
  Medicare reassignment NPD
• Saint Joseph Regional Medical Center, Inc.

  • Pulmonary Disease Physician
  • Plymouth, IN
  • NPI 1225082878
  Medicare reassignment NPD
• Saint Joseph Regional Medical Center- Plymouth Campus Inc

  • Hospitalist Physician
  • Plymouth, IN
  • NPI 1821402876
  NPD
• Saint Joseph Regional Medical Center-South Bend Campus, Inc

  • Critical Care Medicine (Internal Medicine) Physician
  • Mishawaka, IN
  • NPI 1699132365
  NPD
• Saint Joseph Regional Medical Center-South Bend Campus, Inc.

  • Family Medicine Physician
  • South Bend, IN
  • NPI 1396154324
  NPD
• Saint Joseph Regional Medical Center-South Bend Campus, Inc.

  • General Acute Care Hospital
  • Mishawaka, IN
  • NPI 1841245594
  NPD
• Saint Joseph Regional Medical Center, Inc.

  • Family Medicine Physician
  • Mishawaka, IN
  • NPI 1467406074
  NPD
• Saint Joseph Regional Medical Center-South Bend Campus, Inc.

  • Family Medicine Physician
  • Mishawaka, IN
  • NPI 1780766261
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Saint Joseph Regional Medical Center-South Bend Campus, Inc.

  • General Acute Care Hospital
  • Mishawaka, IN
  • NPI 1023965795
  Care Compare affiliation
• Saint Joseph Regional Medical Center-South Bend Campus, Inc.

  • General Acute Care Hospital
  • Mishawaka, IN
  • NPI 1841245594
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1553040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701820800000",
    "number": "1154881993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 E DOUGLAS RD",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465451464",
            "telephone_number": "574-335-6504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 E DOUGLAS RD STE 406",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465451468",
            "telephone_number": "743-335-6580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARP",
        "first_name": "KRISTIN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-20",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IN",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02006676A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300026890",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rithisak Seth, PHARMD
• Wendy Settle, PH.D.
• Ajazuddin Z. Shaikh, M.D.
• Maryam Ahmed Shaikh, MD
• Angelica Sharp
• Charles E Shearer, OD
• Kyle Shelton, DPT
• Dmitriy V Shendel, PHARM D
• Jonathan Neil Shenk, MD
• Edward P. Sheridan, PHARMD, BCPS, BCACP

• Family Medicine Physician in Mishawaka, IN
• Providers in Mishawaka, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.